GP points were used to confirm the presence of a single canal. Apical root resorption complicated achieving an apical stop, leading to slight extrusion of gutta-percha. The patient was informed about the prognosis and the importance of follow-up monitoring.

This case highlighted the challenge of determining restorability in a structurally compromised tooth. Despite a guarded prognosis, the patient was insistent on saving it. Limited diagnostic testing also required reliance on symptoms and clinical findings, reinforcing the importance of flexibility and patient-centered care.

This case involved managing both endodontic infection and acute swelling. The presence of facial swelling emphasized the urgency of drainage and systemic management. Coordinating I&D with RCT and pharmacologic support reinforced the value of staged treatment for optimal healing.

This case emphasized the value of CBCT in confirming canal anatomy and avoiding unnecessary exploration. Completing treatment on an incompletely accessed tooth highlighted the importance of timely intervention to prevent chronic apical pathology.

Restoring these teeth was questionable due to severe wear and limited vertical space. It was important to set expectations about the risk of not being able to place crowns afterward. The patient was still motivated to keep the teeth and chose RCT over extraction.

Managing this patient was tough. He was homeless, had psychiatric issues, and very low tolerance—he even walked out mid-treatment. But with patience and a flexible approach, we were able to complete the treatment. A good reminder that sometimes the biggest challenge isn’t the tooth, it’s the person in the chair.

This case involved a necrotic tooth with an open apex and blunderbuss canal. Achieving apical control was a challenge due to the lack of a natural stop. Apexification was considered, but we managed to adapt a large master cone (#60), trimming the tip to get a snug fit and achieve proper tug-back, allowing us to complete obturation successfully.

The main challenge was the patient’s TMJ discomfort—she had trouble keeping her mouth open and needed multiple breaks. CBCT showed the mesial canals were converging apically, which helped guide shaping. Unfortunately, the distal canal appeared slightly overextended on the final image, reminding me of the importance of precise working length control, especially in cases with limited access.

The main challenge in this case was negotiating calcified canals through an existing crown. Locating the orifice was difficult, but persistence paid off. The final X-ray showed a sealer puff from an accessory canal—right where the sinus tract had traced—suggesting thorough cleaning. With proper disinfection, we’re hopeful this will lead to healing of the fistula. The sealer puff is evident and, given its biocompatibility, not a major concern, though follow-up is essential. 

This patient has rampant caries and a high caries risk. She's on PreviDent and has received dietary counseling and intensive oral hygiene instruction. We had to pause the SMART caries management due to pain on #8. After managing the endodontic issue, a post space was prepared for future post, core, and crown. Temporary restorations were placed, and we’ll continue SMART therapy once she's more stable.

Tooth #21 also has had the cervical external root resorption. This case emphasized the importance of early detection in managing external root resorption. While #29 required RCT due to pulpal necrosis, #21 was identified early and successfully treated with a restoration, preserving vitality.